Healthcare a Hot Item at Town Halls in Virginia, Nebraska

Two House members -- one Democrat, one GOPer -- got very different receptions

ALEXANDRIA, Va. -- Healthcare reform was on the mind of several constituents Monday night as Rep. Don Beyer (D-Va.) held a town hall meeting attended by a respectful audience.

Beyer himself set the stage for the healthcare discussion during his opening remarks, which began with a list of things he said will "always be wrong" -- for example, "It will always be wrong to issue an executive order that bans Muslims."

"It will always be wrong to pass a Trumpcare bill that takes healthcare away from 24 million people," he said, to loud and sustained applause.

Questions About Preexisting Conditions, Public Option

After his brief remarks, Beyer took questions from the audience. "I'm in a wheelchair and my husband has cancer, and we're really worried," one woman said. "Everybody is just kind of wondering what will happen to Medicaid, and all of that security."

"The worst [part] of the Trumpcare bill was that it gave states the ability to waive out of the 10 essential health benefits, and the most important ... benefit is preexisting condition coverage," Beyer said. "As far as I can tell, that's the most popular part of the Affordable Care Act (ACA)."

"The Republicans who voted for it initially said, 'No state will dare do that'" -- that is, no state would dare to opt out of requiring those essential benefits be provided, he continued. "If they won't dare to do that, why put it in [the bill]?"

He added that he thought the ACA's ban on discriminating against people with preexisting conditions would stay. "Every Democrat and many Republicans will be fighting to maintain the preexisting condition [ban], whatever healthcare bill is passed."

Sanjay Sarma, a healthcare consultant and small business owner from Arlington, Va., asked about the possibility of having a single-payer system or at least a "public option" in which people would have the choice of opting into a government-run healthcare plan. He noted that his first year in business, his healthcare costs exceeded his revenue. "Healthcare costs are out of control, and the only way to reduce them is a public option, yet we seem to be getting further and further away from that. What can we do to reverse the tide?" he said.

Beyer acknowledged that the House Republicans' bill did seem to be very far away from such a concept, but added that "a number of people have written that we are getting closer. It becomes obvious that there is no way forward to control costs other than through a public option."

Beyer noted that he has been meeting with people to discuss how to improve the ACA, but said that "the simple solution is to have a public option in every state. Then you don't have to worry about Aetna pulling out or CareFirst increasing premiums by 50%. So I promise you, we'll be pursuing that, although it may take a different Congress to get it passed."

Medicaid Also a Concern

Allison Stover of Mount Vernon, Va. said she was worried about the Republicans' proposal to turn Medicaid into a block grant program. "My family and I went through a long, expensive, and painful journey of Alzheimer's with my mom, who has since died." she said. "When those [block grants] run out, what happens to those Alzheimer's patients, to those people living in nursing homes who have no money? What if you live in a state where the Medicaid money runs out in September? We cannot put those people on the street."

Beyer agreed this was a big problem, noting that the $800 billion cut in Medicaid proposed under the bill "will fall most heavily on older folks with memory issues, and kids with disabilities. This is [House Speaker] Paul Ryan's idea of how you deal with entitlements. Because it's a mandatory expense, there's no way to just say 'Cut this' or 'Cut that.' Instead, they say, we're going to give a block grant to Virginia ... and when the money runs out, too bad."

Mike Rothenberg of Alexandria, Va., who is 2 years away from being eligible for Medicare, said the ACA is working well for him, but he was concerned about the number of insurers withdrawing from the marketplaces. "Do you think some of these insurance companies, once they pull out ... will be coming back?" Beyer said insurers had been coming and going in various state markets even before the ACA, and that this was another reason the public option would be helpful. "One interesting idea is that you could opt everybody into [health insurance]," though they could still decide to opt out later.

But congressional Republicans' plans to repeal and replace the ACA weren't the only healthcare issues on constituents' minds. Kris Gregory of Falls Church, Va. said that she was unhappy about the House passage of H.R. 1181, which made it easier for veterans with severe mental illnesses to purchase guns. She urged Beyer, who voted against the House bill, to work with his Senate colleagues to make sure the bill didn't pass there.

Another woman said she was "concerned about the conservative agenda to overturn Roe v. Wade" -- the Supreme Court decision that legalized abortion nationwide -- which would hurt "the ability of women ... to do with their bodies what is right for them. I'm concerned about the attacks conservatives have made on Planned Parenthood ... Without Planned Parenthood and other healthcare providers like them, women will suffer greatly." Beyer noted that 20% of American women get their reproductive healthcare through Planned Parenthood and said he would be "fighting strong" to make sure the organization was not defunded by the Republicans' bill.

Nebraska Event More Confrontational

Beyer's generally conciliatory event contrasted with a more confrontational town hall held Saturday by Rep. Don Bacon (R-Neb.). In his opening remarks, Bacon said that healthcare costs had displaced "regulation" as the top concern he hears from small businesses, and said he stood by his vote in favor of the House Republicans' bill, known as the American Health Care Act.

His statement earned him a loud round of boos and "Shame!" from the heavily oppositional crowd. Several carried signs with slogans such as "Healthcare no Wealthcare" and "Bacon is bad for you."

The first question came from a 63 year-old man, who asked how he could be expected to get health insurance with rates increasing. Bacon said he thought the creation of high-risk pools to insure those with preexisting conditions would help, blaming cost increases on high-risk patients being charged the same rate as the healthy.

Alex Jesper of Omaha asked why the congressman had voted for the bill before receiving a cost estimate from the Congressional Budget Office (CBO). "We had a CBO estimate on the original bill," Bacon said. "We've improved upon it, and built a better bill."

"Did you read the healthcare bill before voting?" asked Richard Thompson, also of Omaha. Bacon said he had, and that coffee had helped him get through it.

"We've seen examples of this [high-risk] pool structure used, and it worked," he said, adding that he had seen similar plans lead to cost reductions of 30% to 60%. "We won't let it go bad."

One person asked what parts of the AHCA still needed work. Bacon said there needs to be more attention to the rising cost of prescription drugs, and that he would like to see the FDA move faster to get drugs approved. He called for price transparency and an expansion of competition among insurance companies.

Accessibility Statement

At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.